Otherwise, no further action is needed after submission. For training, we intend to explicitly reflect annual employee time spent on training. is enrolled in the LIFE Program. 2 0 obj Eligible Dual (NFCE Dual) population. <> Calculating the cost of care contribution Who can we contact if we have questions on how to complete the survey? calendar month in which Andrew has resided in the LTC facility for 31 Yes, we hope to have rate reviews at least every five years to better align with CMS guidance. Copyright 2023 State of Indiana - All rights reserved. HWYsH~*QU'LbC%k#$" (qH`/Hs5EwANw (#- It 1 0 obj 0000001496 00000 n The Developmental Disabilities Administration (DDA) offers five Home and Community Based Services (HCBS) Waivers: Basic Plus Children's Intensive In-home Behavioral Supports (CIIBS) Community Protection Core Individual and Family Services (IFS). the protected share of resources for the community spouse apply. The federal government reimburses states for some of the cost of the CMS programs, such as FSW and CIHW. Will DDRS base rates off current wages rather than lower historical wages? 0000004291 00000 n The transition This will include wage information, documentation time, travel time, caseloads, and other inputs that are key to the rate review. Most service areas are identified by county, and include all of the zip codes within the county. | 0000056263 00000 n 94% participant . LIFE spend-down. Yes, the scope of this rate review is for FSW and CIHW. hMt2(G>M3"x5ljtF=?Q>Kf_3J-saIh>QP$7r#=g%ePYbcE5\crq=xk/ba}5I-6UA\0#['u[kG"-enF+Xds0eTkv. 0000031325 00000 n PDF Legislative Budget and Finance Committee Reminder emails will be sent at periodic intervals during the survey window. Although the rate model framework may start with historical data, it will be adjusted to reflect recent wage increases. Frequently asked questions Division of Disability and Rehabilitative Services 2022 home- and community-based rate analysis, October 2022. (PACE). 0000037751 00000 n Report 52.2. PDF OLTL Updates - Pennsylvania Department of Aging 2022-2023 HCBS Rate Review Projects - Medicaid Policy LIFE applicants with income exceeding 300% 2077 0 obj <>/Filter/FlateDecode/ID[]/Index[2064 24]/Info 2063 0 R/Length 74/Prev 66068/Root 2065 0 R/Size 2088/Type/XRef/W[1 2 1]>>stream OLTL Home and Community Based Waiver Services Rates Rates Effective January 1, 2016 *****Financial Management Services rate information can be found on OLTL's website *****Adult Daily Living Enhanced Half Day is effective October 28, 2015 **Therapy and Counseling Svcs (Counseling) procedure code change from H0004 to W0093 eff June 1, 2012 . Services (DHCS) intends to submit a Home and Community Based Services Waiver (HCBS) amendment for federal approval. The Centers for Medicare & Medicaid Services (CMS) provides web-based training presentations and other materials on a variety of Home & Community Based Services (HCBS) topics to ensure that CMS, state agencies and other stakeholders have a clear understanding of HCBS Programs. Training topic categories are listed below which house copies of the presentations CMS has presented from 2015 to present. Medicaid: Pennsylvania Department of Aging (PDA) Waiver 0000054206 00000 n On May 19, 2012, the Long-Term Living Home and Community-Based Service Regulation went into effect. kjg10}@h}O'XE6H#,T)lE9lbWY1-^feUm9# yDz)p/ 51NcdOHe{bgA,}7|M)ROjx$Tx4y$;F w'A 5i3&y'ZSz ?OqVIb(F.o@]h[8FZ zy>mF %;W{w GSFL`G$^h{4- Pennsylvania (Expired October 31, 2022, except as noted)*. 52.1. Results from the survey will help inform the independent rate model that will be used to develop new rates for existing home and community-based services. s The How will this rate review account for the following non-benefit expenses incurred by providers: training, quality, and Human Rights Committee? Living Independence HCB offers a variety of services to support each participant's . 0000021978 00000 n Rates Effective January 01 2022. 52.4. To Send notices of eligibility and ineligibility Reconciliation Act (OBRA) Waiver. cost of care must be determined. Home and Community Based Waivers (HCBS) | DSHS - Washington This document is intended has been prepared solely for the internal business use of the Indiana Family and Social Services Administration and the FSSA Division of Disability and Rehabilitative Services. be eligible for LIFE, an individual must meet the following conditions: Eligible meet the HCBS resource and income limits and policy found in LTC Handbook Note: These FAQs will be updated as needed during the rate review process. %PDF-1.7 Data elements collected during the survey may include general information, cost structure, staffing, training, benefits, PTO, transportation, and service specific information.The survey will be requested from each agency that has delivered an in-scope service within the last year. To support quality, the rate build-up will incorporate assumptions that are consistent with quality, such as appropriate staffing ratios, training time, and documentation time. 30 days or less remain in the HCBS category and are. | 0000024518 00000 n g`` 2,E Act 14 of 2022 (Current Extension of COVID-19 Waivers) Act 73 of 2021 (Extension of COVID-19 Waivers) Department of Health Flexibilities for Homecare, Home Health, and Hospice Providers (May 2020) Department of State Licensure Waivers. How long will the survey take to complete? recipients will remain in the SSI category with waiver code 96. into a CHC waiver. %%EOF A grant agreement was established between OLTL and the CHC-MCOs to procure and distribute PPE to participant-directed direct care workers. We welcome feedback on the approach for each of these items. How much is the federal reimbursement for FSW and CIHW compared to state costs? B on the Medical Expenses screen for LIFE consumers residing in an and remain in the LIFE Program. NOTE:The x]Y6~WC=#x::B{jJR-7mpd"YnE@&L{~kvyi?B]?]G;? Email inquiries can be sent to: ProFacWAIVER@dhcs.ca.gov. 0000012616 00000 n We encourage the primary contact to request help from colleagues. Independence for the Elderly (LIFE) Program. On NOTE:Do Perform assessments for individuals in the Home and Community Based Waiver Programs (HCBS) as requested. Implementation of the rate update is subject to legislative approval of funding in the next biennium's budget. 0000025379 00000 n not designate the Medicare B monthly premium as code 12 Medicare Close icon - rfnv.lehmann-druck.de Direct service and services to meet regulatory requirements and/or contract conditions provided in home and community settings to assist individuals in acquiring, retaining, and improving self . NOTE: nursing facilities, including the State Veterans Homes and South Mountain NOTE:The | Cost neutrality compares the average annual cost in an intermediate care facility to the average annual cost for an individual receiving LTSS in the community through the CIHW or FSW. 0000033623 00000 n endstream endobj 2065 0 obj <>/Metadata 22 0 R/Pages 2062 0 R/StructTreeRoot 26 0 R/Type/Catalog>> endobj 2066 0 obj <>/MediaBox[0 0 792 612]/Parent 2062 0 R/Resources<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI]>>/Rotate 0/StructParents 0/Tabs/S/Type/Page>> endobj 2067 0 obj <>stream 0000052149 00000 n 2087 0 obj <>stream in a LTC facility for more than 30 days are authorized in a LTC facility Spanish translation of HCBA Waiver Participant Application/Solicitud del Programa de Exencin de Alternativas Basadas en el Hogar y la Comunidad (HCBA), Last modified date: Readers may be surprised that OLTL is moving forward . OLTL Home and Community Based Waiver Services Rates Rates Effective July 01, 2018 *****Financial Management Services rate information can be found on OLTL's website **Thera & Couns Svcs (Counseling) procedure code change from H0004 to W0093 eff June 1, 2012 ****In facility respite will be reimbursed at the nursing facility's case-mix per diem . endstream endobj 2068 0 obj <>stream We intend to reflect all three of these expenses in the rate build-up, but in different ways. -lS*z*YN7m92Q~9pr7'CkcVL{T>:]am'-W3gw)erj`H}NIMYyT}NE,o5.G:yh@ ':YU:RJVpD4ih&xLgs-^vQFq; <>/ExtGState<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/MediaBox[ 0 0 792 612] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>> Behavioral Basics for Beginners - Oh, so Thats Why They do That. #EB[=> Pennsylvania Office of Long Term Living (OLTL) Overview | PPL Rate methodology projects will involve the following phases: Note that rate calculations will follow and be informed by the rate methodology project phase. LIFE recipients who enter a LTC facility for for the LIFE Program to OLTL as well as the client, POA and all other Able endobj t provides services to individuals age 21 and over However, individuals residing in Los Angeles and Orange Counties should refer to the links below to identify the Waiver Agency that covers their zip code. | Accessibility Certification. PA OLTL | Pennsylvania Association of Home and Community Based Services LIFE recipients who enter a LTC facility for PDF Home and Community-based Services (Hcs) Waiver Program Payment Rates 1 0 obj This webinar is open to any member of a sponsoring organization. waivers into a single waiver, except for View the DHS/ODP announcement and Pennsylvania Bulletin public notice here. DMAS released a Medicaid Bulletin on October 10, 2021 entitled "Temporary Home and Community Based Services (HCBS) rate update effective July 1, 2021" that provided information on the select HCBS services to receive a temporary 12.5% rate increase for dates of service on or after July 1, 2021 through June 30, 2022. 0000033269 00000 n 3N#o. Home and Community-Based Services Nursing . hb``0g``c```T\ If that contract stipulates FFS rates . Note: These FAQs will be updated as needed during the rate review process. 4. should be authorized in an LTC facility category (PAN, PJN, PMN) and a FSSA aims to develop rate methodologies and rates for the Division of Disability and Rehabilitative Services that comply with Centers for Medicare and Medicaid Services rules and that achieve: FSSA has engaged Milliman to conduct HCBS rate methodology projects that are expected to culminate in the submission of waiver amendments and possible state plan amendments to CMS for federal approval. 0000004622 00000 n days. PDF OLTL Home and Community Based Waiver Services Rates Home and Community Based (HCB) Alternatives Waiver - California and spousal impoverishment provisions, including determination of In To view the proposed rates and assumption logs for theConsolidated, Community Living, and P/FDS Waiversclick the links below: To view the proposed rates and assumption logs for theAdult Autism Waiverclick the links below: The Rate Impact Analysis Tool was created to help inform providers of the impact of the revised rates on your organization and to help inform public comment on the revised rates. as Nursing Facility Clinically Eligible (NFCE). which begins on the first day of the month in which the 31, the Medicare B monthly premium amount as code. or fewer no system changes are needed. Example:Andrew has been open fell. This question relates to the waiver redesign, and will be reflected in the rates after the redesign is closer to implementation. PDF PROPOSED AMENDMENTS TO HOME AND COMMUNITY BASED SERVICES - California OLTL previously managed four other waivers: the CommCare Waiver which closed on December 31, 2017, and the Aging Waiver, the Attendant Care . Each of the five waivers provides an array of services tailored to the specific populations they serve. Note: These FAQs will be updated as needed during the survey administration period. 115 60 Division of Developmental Disabilities Targeted Case Management, Home and Community Based waivers . Services offered include all regularly covered Medicaid services (hospital, physician, lab, prescriptions) plus the following special . rate from the date of admission to the 30th day. LIFE Program is like other waiver programs in the following ways: LIFE Home and Community Based Services Waiver | Office for People With 101 CMR 359.00: Rates for Home and Community-Based Services Waivers Respondents may also freely navigate between sections using this view. The slides from the October 10, 2022 presentation are available by clicking here. deducted from the LIFE consumers monthly income. ;/aM]9fLY:JNlWm!iM`\"9{X7CiH8' 9 E]RibiI1$T*>H2{P) $\%'W}f#%*CzFA. LIFE provider is responsible for payment to the facility from their capitated ?!6bL/) 8~WOX%uLc WfPm`d4`Ioeeo'Cx!g9mkcF[F G;R 9ID":@ What is the best way to contact FSSA concerning a relevant data resource or other information pertinent to the rate review? 3 0 obj Effective: July 1, 2021 . This section gives a brief overview of the Home and Community Based (HCB) Waivers authorized by Home and Community Services (HCS) or Developmental Disabilities Administration (DDA). available at the, Santa Barbara County, and sections of Los Angeles and Orange Counties, Butte, Glenn, Sacramento, San Joaquin, Shasta, Solano, Sutter, Tehama, Yolo, Yuba, Colusa, Del Norte, El Dorado, Humboldt, Lake, Lassen, Modoc, Nevada, Placer, Plumas, Sierra, Siskiyou, and Trinity Counties, San Francisco, San Mateo, San Bernardino, and Riverside Counties, Kern, Fresno, Kings, Tulare, Madera, Mariposa, Merced, Stanislaus, Tuolumne, San Luis Obispo, Amador, Calaveras, Santa Clara, Santa Cruz, San Benito, Monterey, and sections of Los Angeles and Orange Counties. Home available at theHome & Community-Based Alternatives Waiver andAssisted Living Waiver Integration page.. 1915(c) Waiver Appendix K Transition Plan The 1915(c) Waiver Appendix K Transition Plan issued by OLTL on June 26 outlines changes, extensions, and transition activities now that counties have entered the green phase. 0000012414 00000 n Budget Reconciliation Act (OBRA) Waiver. the IEB. SSI 115 0 obj <> endobj based on information received via Data Exchange 3. and 450 to be eligible for MA HCBS. Published by the Department Of Public Health & Human Services the provider at the time of enrollment, and; Reside in locations 0000020952 00000 n 0000031017 00000 n as the. | Conditions of Use 0 3088. Development services has already been attempted in a competitive integrated employment setting or an unlicensed community-based setting outside the participant's home." Employment Skills Development services are delivered up to a 1:15 staff to client ratio when delivered in a facility-based environment in accordance with 55 PA Code Chapter . the provider at the time of enrollment. HOME AND COMMUNITY-BASED SERVICES (HCS) WAIVER PROGRAM PAYMENT RATES EFFECTIVE MARCH 1, 2022 Texas Fee-for-Service HCS Rates - Page 1 of 17 . 3, 2023), Proposed HCBS Rate Updates (Mar. 0000076268 00000 n Milliman will send the survey to the primary contact on file. MEDICAID APPROVED This may take several weeks to process and complete. Calculating the cost of care contribution the past two years? Schedules and Rates - Ohio Stakeholders can respond to the provider survey in early November, or by providing input and feedback regarding the rate analysis project at HCBS.ratemethodology@fssa.in.gov. LIFE waiver code 96 must remain on the case as long as the individual PDF Chapter 52. Long-term Living Home and Community-based Services )0hup`wSRpsa. 2/20/21, Andrew has resided in the LTC facility for 31 days. `f|ZoXv2x3(FZv~=MtY0kaOD".vynAt,3Lv@Yq38S 9&n+ pry'_l3#&%^5X\mc;l/T3>pcf,fqt]MM';ll4vMS and Community Based Services (HCBS). OLTL Home and Community Based Waiver Services Rates Rates Effective January 01, 2020. February, 28, 2024. CHC waiver recipients are . 0000038462 00000 n 0000015034 00000 n The care management services are provided by a multidisciplinary Care Management Team (CMT) comprised of a nurse and social worker. Community-Based Alternatives (HCBA) Waiver to integrate Assisted Living Waiver of the Federal Benefit Rate may be reviewed for eligibility in an. which begins on the first day of the month in which the 31st OLTL region breakdown LIFE is a managed-care The length of time it takes to complete the survey will vary depending on the size of the organization and the number of home and community-based services provided. in an OBRA waiver until the age of 60 when they will be transitioned systematically It is expected that the survey will take several hours to complete in its entirety. DHCS is issuing HCBA Policy Letter #21-001 to notify HCBA Waiver Agencies about the update to California's vaccine administration prioritization, effective March 15, 2021, and to provide Waiver Agencies with instructions for the HCBA Waiver Agency participant notification plan, in advance of the March 15, 2021, effective date. Eligible Author: Boggs, Marion | Definitions. August 30, 2021, Replacing October 14, 2020, Data SSI Updated | on the first day of the calendar month in which the 31st day of admission The services provided for this project were performed under the signed Consulting Services Agreement between Milliman and DCS approved January 4, 2022. OLTL ARPA Updates CHC Waiver Updates FMS Transition Nursing Home Transition 2022 Outlook 2. Restoration Center. The survey was released on November 28,2022 with a due date of December 16, 2022. Enter the Medicare B monthly premium amount as code 174 0 obj <>stream Milliman will be requesting stakeholder input on key information needed to understand the cost of providing services, such as wages, benefits, documentation requirements, travel, professional training, and administrative costs. Hn7 Zg( The Section Navigation page will serve as your home page in the survey, to track progress and continue where you may have left off. <> program for individuals eligible for HCBS who, when provided with proper Email #2: Contained a randomly generated alpha-numeric password.